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Neuro Disorders > Muscle Tone > Flashcards

Muscle Tone Flashcards

1
Q

Muscle Tone

A
  • The amount of stiffness in a resting muscle/resistance offered by muscles to stretch or passive elongation (stiffness)
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2
Q

Factors that influence muscle tone

A
  • Body position & interaction of tonic reflexes
  • Stress & anxiety
  • Volitional effort and movement
  • Medications
  • General health
  • Environmental temperature
  • State of arousal or alertness (CNS)
  • Fevers, infections, bladder fullness, pain, etc.
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3
Q

Intrinsic stiffness causing muscle tone

A

Weak actin-myosin bonds

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4
Q

Passive stiffness causing muscle tone

A

Titin

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5
Q

Hypotonia

A
  • Decreased resistance to passive movement/muscle being lengthened
  • Decreased DTRs
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6
Q

Flaccidity

A
  • Complete loss of muscle tone
  • Most severe form of hypotonia
  • Seen after acute stroke, LMN injury, SCI, and alpha motor neuron disease (ALS)
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7
Q

Hypertonia

A
  • Abnormally strong resistance to passive stretch
  • Two types: Spastic and Rigid
  • Seen with UMN ONLY
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8
Q

Dystonia

A
  • Basal ganglia disorder
  • Involuntary muscle contractions causing abnormal twisting movements or postures
  • Worsened by stress, fatigue, and pain
  • Movements make it more difficult to talk, but no impairments with speech centers
  • Minimized/stopped with sleeping
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9
Q

Populations that present with hypotonia

A
  • Anterior horn cell pathology
  • Partial peripheral nerve lesions
  • Lesions of CNS: Spinocerebellar lesions, some types of developmental delays, some forms of cerebral palsy
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10
Q

Important things to look out for with hypotonicity

A
  • Joint dislocation/subluxation
  • Balance issues
  • Airway and swallowing
  • Muscle atrophy can lead to contractures
  • Skin issues
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11
Q

Spastic Hypertonia

A
  • Velocity dependent increase in tonic stretch reflexes (muscle tone) and exaggerated DTRs
  • Clasp-knife reflex, clonus, or positive Babinski may be present
  • Caused from lesion in descending motor pathways
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12
Q

Clinical implications of spastic hypertonia

A
  • High risk for developing contractures
  • Skin integrity issues
  • Joint subluxation
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13
Q

Rigid hypertonia

A
  • Velocity independent resistance to stretch that is increased on BOTH sides of a joint in agonists and antagonists throughout the range; DTRs normal
  • Types: Cog wheel & lead pipe
  • Seen with diseases of basal ganglia (Parkinson’s) and late stage Alzheimer’s
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14
Q

Clinical implications of rigid hypertonia

A
  • Difficulty initiating movement
  • Range of motion & loss in muscle length
  • Stiff trunk causes breathing issues
  • Contractures
  • Skin issues from weight loss
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15
Q

Decorticate Rigidity

A
  • Sustained contracture & posturing where trunk and LE are in extension and UE in flexion with clenched wrists and fingers
  • Occurs in lesions above middle of midbrain; damage to corticospinal tract
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16
Q

Decerebrate Rigidity

A
  • Sustained rigid muscle contractions and posturing of the trunk and limbs in full extension
  • Lesions below the middle of the midbrain, usually at brainstem
  • Worse prognostically than decorticate rigidity
17
Q

Opisthotonic Rigidity

A
  • Body is held in abnormal posture involving rigidity and severe arching of the back, with the head thrown backwards
  • More common in infants (with high fever, meningitis, encephalitis) and more exaggerated in adults with immature CNS (CNS vasculitis, encephalitis, meningitis)
18
Q

Clinical Examination of Muscle Tone

A
  1. Observation of resting posture/alignment
  2. Passive movement testing (tonic stretch reflexes)
  3. Active movement tests
  4. Palpation
  5. Postural control
19
Q

Modified Ashworth Scale

A 
0 = no increase in muscle tone
1= slight increase in muscle tone manifested by catch or release or by minimal resistance at the end of ROM
1+ = slight increase in muscle tone, manifested by catch & release followed by minimal resistance throughout remainder of ROM
2 = More marked increase in tone through most of the ROM but affected part can still be moved
3 = Considerable increase in tone; passive movement throughout the ROM
4 = Affected parts held rigidly in place
20
Q

Treatments of Abnormal Tone

A
  1. Medical Management
  2. Surgical Management
  3. Physical interventions (PT)

Neuro Disorders (14 decks)

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